Comparison of specificity and sensitivity of diagnostic methods of postmenopausal osteoporosis in patients with type 2 diabetes mellitus
G.M. Nurullina, G.I. Akhmadullina
Izhevsk State Medical Academy, 281 Kommunarov Street, Izhevsk, Russian Federation, 426034
Nurullina G.M. — post-graduate student of the Department of Faculty Therapy with courses of Endocrinology and Hematology, tel. (3412) 46-55-83, e-mail: dalllila@mail.ru
Akhmadullina G.I. — Cand. Med. Sc., Associate Professor of the Department of Faculty Therapy with courses of Endocrinology and Hematology, tel. (3412) 46-55-83, e-mail: guzal-work@mail.ru
Objective: to evaluate the sensitivity, specificity, and prognostic significance of the FRAX and DXA instrument in the diagnosis of postmenopausal osteoporosis (PO) in patients with type 2 diabetes mellitus (T2DM).
Materials and methods: we examined 201 women aged 51 to 68 years, among them 39 patients with CD2 and PO, 162 patients with T2DM without signs of PO. Patients were examined for bone mineral density (BMD) using DXA of the spine and hip and the 10-year probability of major osteoporotic fractures was calculated with FRAX tool.
Results: the sensitivity and specificity of FRAX in the diagnostics of PO without BMD of the femoral neck was 13.16 % and 100 % respectively, with BMD of the femoral neck — 25.92 % and 100 %, with the inclusion of T2DM in the secondary osteoporosis — 81.58 % and 98.77 %. FRAX demonstrated statistically significant excellent predictive value by results of ROC-analysis for all ages of the observation groups, and the inclusion of T2DM in secondary osteoporosis had no advantages. DXA of spine and hip in the study showed better sensitivity compared to FRAX without femoral neck (25 %), but a lower predictive value, the specificity was 100 %. The cutoff point of the T-score L1-L4 (≤ -1.2 SD), T-score of femoral neck (≤ -0.9 SD), T-score of total hip (≤ -0.5 SD), in which the majority of patients had a history of low-energy fractures, is significantly higher than the value according to WHO classification of osteoporosis.
Conclusions: the FRAX calculator without femoral neck showed a lower sensitivity, but a significantly higher predictive value than the DXA of spine and hip in the diagnosis of postmenopausal osteoporosis in patients with T2DM.
Key words: DXA, FRAX, type 2 diabetes mellitus, postmenopausal osteoporosis, diagnostics.
(For citation: Nurullina G.M., Akhmadullina G.I. Comparison of specificity and sensitivity of diagnostic methods of postmenopausal osteoporosis in patients with type 2 diabetes mellitus. Practical Medicine. 2018)
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